Changes To Community Stoma Care Nursing Due To the Pandemic
From March 2020 coronavirus has changed the way we have all had to work, especially in the community.
Since the beginning of 2020, there have been so many changes in our lives, at work and at home. Different guidance, policies and procedures to follow, we’ve been put into lockdown and put into lockdown again, and a third time!
I deal with it the best way I can… by using my PPE and following procedures.
Changes to our nursing practice mean that during home visits we have had to minimise patient contact for the patient’s safety and our own. Home visits are only necessary if we cannot help people over the telephone. Where we can, we provide reviews by video call, which has become normal for us. Many new policies and procedures have come into effect, accompanied by lots of online learning.
A nurse will only conduct a home visit if all other means of communicating have been exhausted. When we enter someone’s home, we will try and limit the time we’re there and avoid contact. It’s an anxious time for everyone. Especially as touch, which is the most basic comfort, is no more.
Some of the changes have been challenging. When nurses wear masks it can be difficult for those with hearing difficulties, or rely on lip reading, to understand. The protection is essential because Covid-19 is passed from our noses and mouths. But what can we do to keep the mask as a virus barrier, but not a communication barrier? Where we can, we give more time and support to those we care for; writing down instructions and using visual aids has helped to break down some of the barriers.
Covid-19 has been challenging for those with dementia or learning difficulties. “Why are we wearing these masks?” In the beginning, patients felt uneasy because they couldn’t see our faces. The fact that we had to ask for minimal people in the room also felt uncomfortable, it is their home after all!
We have managed to conduct stoma care virtually, and successfully.
Virtual reviews work well for most patients, with some requesting virtual reviews to continue in the future. It saves the patient a trip out of the house, potentially catching public transport and working appointments into busy schedules. However, some problems would have been resolved quicker face to face. Where we can, we have offered much needed extra support and adapted to the problem. Continuing stoma reviews virtually could free up slots in a usually very busy clinic too, if it remains beneficial to our patients.
As a stoma care nursing team, we have used video calls to be an essential part of our working lives. It gives us chance to reflect and help each other through difficult circumstances. We all need support sometimes. It has not been an easy time for any of us.
I have always tried to put the patient’s needs first and have continued to provide a caring supportive stoma care service.
At times I have gone above and beyond in trying to support my patients. I’ve spent time teaching people how to send photos and shown them how to set up and use video call.
We’ve been forced to change the way we teach family members and carers. Where we can, we make as little contact as possible, making space and limiting the amount of people we teach. I have written and drawn visual plans for carers to make pouch changing easier for them too.
Although my nursing role has changed, I have adapted and tried to do the best I can with circumstances which are beyond my control. I feel proud that I have coped, managed to get along at work, and at home. I feel privileged to continue to work as many others are forced to look for new jobs.
Adjusting to working independently, mainly from home, has its challenges. It is easier to visit patients to help them face to face, after all nursing is hands on. Sitting at a computer doesn’t feel like nursing to me.
The vaccine gives us hope for more of a normal future, our routines and our lives back.
Some positives have come from this… I have received my first vaccine and have the second booked. I’m excited for the relaxing of restrictions and am looking forward to going back to the old-style community nursing. We’re all excited to get our lives back, me included. So let’s continue to stay safe so we can say goodbye to this pandemic!
“I have always tried to put the patient’s needs first and have continued to provide a caring supportive stoma care service.” – Sharon Leighton, Stoma Care Nurse